Which statement describes the degenerative lamellar macular hole?

Which statement describes the degenerative lamellar macular hole?

• A. Not full thickness, no lifting seen between retinal layers.
• B. Macular hole that begins to lift the retina normally between OPL and ONL.
• C. Not full thickness, but begins to progress laterally out into sides of retinal layers.
• D. Full thickness macular hole.

Answer: (C)

The key idea is that a degenerative lamellar macular hole is a partial-thickness defect of the fovea that tends to spread laterally through the retinal layers rather than creating a full-thickness hole or a vertical split. In this type, you see loss confined to the outer retina with irregular foveal contour and a tendency for tissue loss to extend sideways along the retinal planes, not to perforate through all layers. On OCT, this appears as a partial-thickness defect with outer retinal disruption and a schisis-like appearance, evolving more horizontally across the macula. That lateral expansion is what distinguishes it from a full-thickness hole, and from other LMH descriptions that emphasize vertical lifting or traction. So the statement describing the degenerative form best is the one that notes it is not full thickness and that the hole progresses laterally into the sides of the retinal layers. The other options describe features that don’t match this pattern: a defect that lacks any layer lifting isn’t typical of degenerative LMH, a vertical lifting between specific layers implies a different mechanism, and a full-thickness hole is not a lamellar (partial-thickness) hole.

The key idea is that a degenerative lamellar macular hole is a partial-thickness defect of the fovea that tends to spread laterally through the retinal layers rather than creating a full-thickness hole or a vertical split. In this type, you see loss confined to the outer retina with irregular foveal contour and a tendency for tissue loss to extend sideways along the retinal planes, not to perforate through all layers.

On OCT, this appears as a partial-thickness defect with outer retinal disruption and a schisis-like appearance, evolving more horizontally across the macula. That lateral expansion is what distinguishes it from a full-thickness hole, and from other LMH descriptions that emphasize vertical lifting or traction.

So the statement describing the degenerative form best is the one that notes it is not full thickness and that the hole progresses laterally into the sides of the retinal layers. The other options describe features that don’t match this pattern: a defect that lacks any layer lifting isn’t typical of degenerative LMH, a vertical lifting between specific layers implies a different mechanism, and a full-thickness hole is not a lamellar (partial-thickness) hole.